Group Counseling for Mothers After Emergency Cesarean Section: A Randomized Controlled Trial of Intervention

Authors

  • Elsa Lena Ryding MD, PhD,

    Corresponding author
      Dr Elsa Lena Ryding, Department of Obstetrics and Gynecology, Karolinska University Hospital, SE 171 76 Stockholm, Sweden.
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  • Ewa Wirén RN, RM,

  • Gunilla Johansson,

  • Barbro Ceder,

  • Anne-Marie Dahlström RN, RM


  • Elsa Lena Ryding is a senior consultant at the Psychosomatic Unit of the Department of Obstetrics and Gynecology, Karolinska Hospital, Stockholm; Ewa Wirén and Anne-Marie Dahlström are delivery ward midwives; and Gunilla Johansson and Barbro Ceder are maternity and child welfare psychologists at the Department of Children's and Women's Health, Helsingborg Hospital, Helsingborg, Sweden.

  • This study was funded by a research grant from the Thorsten-Birger Segerfalk Foundation, Helsingborg, Sweden.

Dr Elsa Lena Ryding, Department of Obstetrics and Gynecology, Karolinska University Hospital, SE 171 76 Stockholm, Sweden.

Abstract

Abstract: Background: An emergency cesarean section is often a traumatic experience for women, and can be associated with postnatal depression and posttraumatic stress. Various types of interventions have been tested to prevent such consequences. The purpose of this study was to test a model of group counseling for mothers after emergency cesarean section, and to examine its possible effects. Method: After undergoing an emergency cesarean section, 162 Swedish-speaking women were randomized to group counseling or the control group. The participation rate was 75 percent. The counseling consisted of 2 sessions, conducted at about 2 months postpartum; 72 percent of the women randomized to the counseling group actually attended the sessions. At 6 months postpartum, all study participants completed a postal questionnaire (response rates were 92% in the counseling group and 89% in the control group). Results: No difference between the groups was found in terms of the level of fear after childbirth, symptoms of posttraumatic stress, or postnatal depression at 6 months after the emergency cesarean. The group counseling was much appreciated by the participating women, some of whose experiences are reported in this paper. Conclusion: Group counseling for mothers after emergency cesarean section did not influence their views on the recent delivery or prevent symptoms of posttraumatic stress or postnatal depression. It was, however, appreciated and did no harm. In future studies, other outcomes should be measured.

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